A systematic review evaluates transcranial direct current stimulation’s impact on cognitive function in post-stroke cognitive impairment, suggesting timing matters.
BACKGROUND: Post-stroke cognitive impairment (PSCI) significantly hinders recovery. Transcranial direct current stimulation (tDCS) is a promising intervention, yet its efficacy varies, and the optimal therapeutic window remains debated. OBJECTIVES: To evaluate the efficacy of tDCS on global cognition, memory, and executive function in PSCI and determine if stroke onset duration influences treatment outcomes. METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) searched from databases including PubMed, Embase, and Cochrane Library up to January 2026. Outcomes included Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), memory, and executive function. Subgroup analyses stratified patients by stroke chronicity (<6 months vs. >6 months). RESULTS: Twenty RCTs involving 772 patients were included. tDCS significantly improved global cognition (MoCA: MD = 2.11, 95% CI [0.93, 3.30], CONCLUSIONS: tDCS effectively enhances cognition in PSCI. However, efficacy is time-dependent, suggesting a "critical window" for intervention within the first 6 months post-stroke. Early application is recommended. REGISTRATION NUMBER: CRD42024543596.
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